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HealthPhone™: Exercise 1 - Severe Acute Malnutrition - Assessing for Presence of Severe Acute Malnutrition

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Exercise 1 Assessing for Presence of Severe Acute Malnutrition

Exercise 1: Mid Upper Arm's Circumference Measurement and Checking for Edema

Almas Habitsho, 24 months old, was sent by community volunteers from Koroguti to Alaba health post for further nutritional evaluation.

Almas' mother reported that the child was suffering from on-and-off type of watery diarrhea, 3 to 4 times per day, for more than a month, but the diarrhea has stopped two weeks ago.

The mother also mention that Almas was vaccinated completely, but the vaccination card was lost.

She did not take vitamin A supplemantation and tablets for intestinal worms during the last month's campaign.

Almas has not been breastfeeding since 6 months ago.

She's taking whatever food is available at home.

The health extension worker asks the mother to keep Almas standing erect and removes the cloathing that covers her left arm.

The health extension worker will estimate the mid point of the left upper arm

Straight up the arm and wrap the Mid Upper Arm's Circumference tape around the mid point, making sure the numbers are right side up.

The health extension worker makes sure the tape is flat around the skin and the tension is not to tight or loose.

The health extension worker reads the Mid Upper Arm's Circumference and records the reading.

Please write the Mid Upper Arm's Circumference measurement of Almas that you read

How much did you read?

We read that the Mid Upper Arm's Circumference of Almas to be 10.4 cm.

What is your interpretation of the Mid Upper Arm's Circumference measurement of Almas?

Is she severily malnourished, based on the Mid Upper Arm's Circumference measurement?

A child aged 6 months to 18 years has Severe Acute Malnutrition,

if the Mid Upper Arm's Circumference measurement is less than 11 cm.

The Mid Upper Arm's Circumference measurement of Almas is 10.4 cm and she is 24 months old.

Therefore, Almas has Severe Acute Malnutrition, since her Mid Upper Arm's Circumference measurement is less than 11 cm.

Health extension worker will apply normal thumb pressure on both feet of Almas for 3 seconds and check for the presence of shallow print.

Do you see shallow print or indentation on both feet?

Does Almas has pitting edema of both feet?

We didn't see any shallow print, therefore Almas does not have pitting edema of both feet.

Pitting edema of both feet should be present in case of nutritional edema which is a sign of Severe Acute Malnutrition.

The Mid Upper Arm's Circumference measurement of Almas is 10.4 cm. and she does not have pitting edema of both feet.

Almas has Severe Acute Malnutrition, because her Mid Upper Arm's Circumference measurement is less than 11 cm.

Zuria brought her twelve month child Tariku to the health post, after being worried about the swelling of both feet.

The swelling started to appear 3 weeks ago and the mother tried to apply some herbal medication but got no improvement. Tariku has no cough, blood in the stool but has on-and-off fever. He has no abnormal body movement and has been vomiting one to two times per day

Tariku is vaccinated regurlaly up to nine months in the health post and all the records are available.

Zurias mentioned that they are living in the Kohla part of SNMPR.

Do you think Tariku has pitting edema of both feet?

We have seen shallow print on both feet after applying thumb pressure for 3 seconds.

Therefore, Tariku has pitting edema of both feet.

Does Tariku have Severe Acute Malnutrition?

Tariku has Severe Acute Malnutrition because he has pitting edema of both feet.

Jamila has brought her 13 months old child Mohammed to health post for nutritional checkup.

Mohammed has no edema on the feet, and has no cough, fever or diarrhea.

Jamila is worried that her child doesn't look strong, like other children of the same age in the community.

The mother mentioned Mohammed took all the vaccinations as per appointement.

Do you see any indentation on Mohammed's feet?

Does he have pitting edema of both feet?

We didn't see any indentation on both feet, therefore Mohammed doesn't have pitting edema of both feet.

The health extension worker will do the Mid Upper Arm's Circumference measurement.

Please write the Mid Upper Arm's Circumference measurement of Mohammed that you read.

How much did you read?

The Mid Upper Arm's Circumference measurement of Mohammed is 11.6 cm.

Therefore, he has Moderate Acute Malnutrition, since the Mid Upper Arm's Circumference greater or equal to 11 cm and less than 12 cm and no edema.

Mohammed does not have Severe Acute Malnutration, but he does have Moderate Acute Malnutrition.

Video Details

Duration: 6 minutes and 1 second
Year: 2009
Country: Ethiopia
Language: English
Producer: Federal Ministry of Health and UNICEF, Ethiopia
Views: 893
Posted by: nand on Feb 11, 2012

Intended for Health Extension Workers (HEW) on how to do screening for malnutrition, how to identify Severe Acute Malnutrition cases; and how to conduct Out-Patient Therapeutic Programme for SAM in order to maximize the coverage and improve the quality of services provided to SAM cases at the community level.

Management of Severe Acute Malnutrition and Out Patient Therapeutic Program Training Material - Federal Ministry of Health and UNICEF, Ethiopia

visit us on-line at http://healthphone.org

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